Patient characteristics and admitting vital signs associated with COVID-19 related mortality among patients admitted with non-critical illness

OBJECTIVE: Determine risk factors for mortality among COVID-19 patients admitted to a system of community hospitals in the United States DESIGN: Retrospective analysis of patient data collected from the routine care of COVID-19 patients SETTING: System of more than 180 acute care facilities in the United States PARTICIPANTS: All admitted patients with positive identification of COVID-19 and a documented discharge as of May 12, 2020 METHODS: Determination of demographic characteristics, vital signs at admission, patient comorbidities and recorded discharge disposition in this population to construct a logistic regression estimating the odds of mortality, particular for those patients characterized as not being critically ill at admission RESULTS: A total of 6180 COVID-19+ patients were identified as of May 12, 2020 The majority of COVID-19+ patients (77 8%, 4808) were admitted directly to a medical/surgical unit with no documented critical care or mechanical ventilation within 8 hours of admission After adjusting for demographic characteristics, comorbidities, and vital signs at admission in this subgroup, the largest driver of the odds of mortality was patient age (OR: 1 07, 95% CI 1 06-1 08, p< 0 001) Decreased oxygen saturation at admission was associated with increased odds of mortality (OR: 1 09, 95% CI 1 06-1 12, p< 0 001) as was diabetes (OR: 1 57, 95% CI 1 21-2 03, p<0 001) CONCLUSIONS: The identification of factors observable at admission that are associated with mortality in COVID-19 patients who are initially admitted to non-critical care units may help care providers, hospital epidemiologists, and hospital safety experts better plan for the care of these patients